7822 BEVERLY LN A 2016-01-01 MF Import

The Puget Sound Clean Air Agcncy requires advance notification beCore eny person commences a frieble asbcstos project involving materials equal to or grcnta in size thnn 10 linear fect or 48 square fcet and for all demolition projects (regerdless of asbestos contenQ involving shvctures with a projected roof atca greater then 120 square feet (Regulation Ill, Article 4). All asbestos romovnl and demolition notifications must be submitted to the Agency on curtcnt Agency fortns. Asbestos rcmoval end demolition proiects involvin¢ matmalt and swcNres below the notification thmshold are still subiect to all other requimnrnts of Reeulntion III. Article 4. ARer rcceiving a complete notification with the appropriate projcct fee, the Agency will review thc fortn and retum a copy to the asbestos and demolition contractor by mnil. The retumed copy witl be your validated notification. �or: �, � f�►Jctc�"t CtilPS o.h,Riceo: c.el� V9I'e� conuacror': Addras: xri)� �1%l�Y"C� L•a,tic Phonr. � �T9`p7 Jobq: State: �V�� I ZiP: I. O2� J I Fax: GUIDELINES FOR SUBMITTIiVG AN ASBESTOSIDEMOLITION NOTIFICATION Step 1. Check the appropriate projxt cype in Uo: A. Friable asbesros includes popcom ceiling material, sheet vinyl iloonng, cement asbestos board siding, and duct insulation. Nonti iable asbestos i� t.ortnally found in vinyl floor tilcs, window putty and most rooting materials. Step 2. Enter property owner infortnation in Boz B. Step 3. Fnter Ihe asbestos contractor or property owner infocmation, if the property owner is conducting a single-family residential project, in Bo: C. Print clearly this is your renun mailing label. Step 4. Enter the sitc address Cor all notifications in Box D. For multiple-shucture projects, attach supplemental s6mt with a site map (include an address (or each sitc) and a list of the type and amount of Giable asbestos to be rcmoved from each swcture. Step 5. Check either asbcstos survey or matcrial presumed in Bo: E. All demolitions requirc an Asbestos Hazard Emergrncy Response Act (AHERA) asbestos sutvey be conducted by an AHERA certified building Inspeceor. Attach a coov of the survev results to the notifica[ion of a demolition oroiect when onlv nonfriable asbestos or no asbestos is idmtified on the survey, Step 6. Enter the project infortnation in Boz F. and check the training fire or ordercd demolition if appropriate (a copy of the oftcial order must be attached). All asbestos must be removed prior ro conducting a training fire. AJditional training fire mquirements are contained in Reguladon 1, Section 8.08. IC any nonfriable asbestos materials will he left in place during demolition, check yes and lisc the typc and quantiry of matcrial. Note: Demolition debris containing nonfriable ubestos materials must be labeled as "nonfriable asbestus-containing waste" and he deposited at an authorized waste disposal faciliry. Step 7. Enter asbestos project infortnation in Box G. List types o( Criable asbesros material to be removed; surCacing material such as popcom ceilings or plaster, shect vinyl Ilcwring, duct and pipe insulation, cemeut asbesros board siding or pipe, etc. Slep 9. For Single-Famlly ResidenNal proj^ "s; check 60X N1A Cor renovatton projec�s, BOX H18 Cor demollHon projatc (with or without asbestos rcmoval). hsbestos removal may be conducted after a complete notification is mceived, but demolition activiues cnn only bcgin on the 10t° day afler thc notification is rcceived. Naa: lJthe single family sesidence is owned by one jami/y who has been ur wi!! be using the resrdence as their Jomicile, baxes !A or IR may be checked A sing(e jamAy residence does not indude rental property, multi family uniu, or any mired-use building. For Commerclal asbestos projects (or projects that do not quali(y as Single Family Residenttal); check the project category H2 - 5 that matches the amount of friable asbestos that will be rcmoved. If a demolition is involved, include the appropriate surc6arge (additional� fee) i:i your payment. To file for an emergency asbestos or demolition project, check the appropriate box I- 5 and �he applicable emergency box in H6. All emereencv requests mact lx accomunnied bv n letter from the oropettv owner demonstratine Ihe need to conduct the oroia:t immediatelv in accordance with �he reauirements in Reeularion III Section 4.03 (cl. Step 9. Please certify the accuracy and wmpleteness of the infomu�tion provideA by slgn[ng the norification in Hox I. Mandatory amendmenls to the notification are mquired (or changes that incrense t6e project caregory, change the types of asbestos matenals to be removed and changes to start date, completion dete and work sc6edule for asbestos projects. No fee is required Cor work schedule changes if the wnvacror is participating in the Agrncy work sc6edule fax progr�m. A 525.00 processing fee is rcquued for all amendmenes. Puget Sound Clean Air Agency asbestos regulations nnd formc can download from the Agency web page at www.pse�eanaicorg. Fur technical assisu�ncc contact (206) 689-4058 and for administrative inquiries con�act (206) 689-3090. _ _ . _. . _ .. ., .. ...,.., .,. C./